Pat Schan, Retired Midwife and Clinical Advisor, SHA CC Member
Last month, the RCM published an article entitled Safe staffing = Safe care calling on policymakers to take urgent action. Working hours have long been an issue for midwives and are often given as a cause for leaving the profession. In other safety-critical industries such as aviation, strict limits exist on working hours and obligatory breaks are mandated. No such protections are given to midwives, who often work all day and go straight onto an on-call shift. As a community midwife, I worked many shifts of 20hours without a break.
Midwives are expected to work without the protection of safe rest breaks between shifts and often work entire shifts (mostly 12hr) without a meal break -it has become almost expected. Midwifery is a demanding profession, physically and mentally and tired midwives are a preventable risk.
Leah Hazard, Midwife, writer and advocate for safer maternity, has written how Working Time Regulations (WTR) are routinely flouted, and many staff are expected to opt out of WTR as part of their terms of employment. She talks about how fatigue has been proven to cause cognitive impairment and how midwives have shared with her experiences of coming to and causing significant harm due to exhaustion and making clinical errors.
In December, Baroness Amos published her interim report on maternity and neonatal services in England. Having been appointed by the Secretary of State, Wes Streeting her brief was to act urgently to improve care and safety.
This followed several reports going back to 2015 when the report into Morecambe Bay NHS trust first identified serious failures of clinical care leading to unnecessary deaths and serious harm to mothers and babies
All these reports had clear recommendations around staffing and clinical competence, working relationships, incident reporting and investigation, complaint handling and clinical leadership but staff exhaustion doesn’t appear to be given the attention it needs. Leah Hazard has started a petition demanding that legally enforceable role-specific limits on midwives’ working hours be established as a matter of urgency.
The SHA Maternity working group will support this initiative as part of our continuing dialogue with MPs about the dire state of maternity services and the dangers this presents to midwifery as a profession. Sign the petition, “Establish legal limits on midwives’ working hours”, here.